Clinic Timings Peshawar: Mon–Fri 2–7 PM Lahore: Sat 9 AM–4 PM Islamabad: Sun 9 AM–4 PM Khattak Medical Center, Dabgari Garden, Peshawar
Thoracic Surgery

Treatment for Pleural Effusion and Empyema in Peshawar

Fluid or pus collecting around the lung stops it expanding and does not always drain with a tube alone. Dr. Muhibullah Dawar performs drainage and decortication, including for the thick, organized empyema that follows tuberculosis.

Written and reviewed by Dr. Muhibullah Dawar, FCPS (General Surgery) Last updated 2026-09-07

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Key takeaways: Pleural Effusion and Empyema

  • When a drain is not enough — Early pus drains through a tube. Once it has organized into thick loculated collections wrapped in a peel of fibrous tissue, a drain passes straight through it and the lung stays trapped. That is the point at which surgery is needed.
  • Signs of fluid or pus around the lung — Breathlessness that has been getting worse.
  • Assessed and performed at Advance Surgery Clinic, Dabgari Garden, Peshawar.

What are pleural effusion and empyema?

The pleural space is the thin gap between the lung and the chest wall. A pleural effusion is fluid collecting in it; an empyema is infected fluid — pus. Either compresses the lung, and the symptoms are breathlessness, chest pain and, with infection, fever and weight loss.

Treatment escalates with the stage. Simple effusions are aspirated or drained with a tube. Empyema that has begun to loculate may respond to a drain plus fibrinolytics. An organized, chronic empyema has a thick fibrous peel over the lung that has to be peeled away surgically — a decortication — to let the lung re-expand. In this region, tuberculosis is a leading cause of exactly this picture.

Assessed before any treatment is recommended.

Signs of fluid or pus around the lung

  • Breathlessness that has been getting worse
  • Chest pain that is sharper on breathing in
  • Fever, night sweats or weight loss
  • A cough that will not settle
  • Fluid reported on a chest X-ray, ultrasound or CT
  • A chest infection that has not responded to antibiotics

An early assessment is what keeps the options open.

Questions before booking?

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FAQs

Frequently asked questions

The questions patients ask most often before booking this procedure.

Only at the earliest stage. Once pus has collected it has to be drained, and once it has organized into a thick peel it needs surgical decortication.

The surgical removal of the thick fibrous layer that has formed over the lung and is preventing it from expanding. Peeling it off allows the lung to re-inflate.

That depends on how long it was trapped and how much underlying lung damage there is. Earlier surgery generally gives better re-expansion.

Yes. Tuberculous empyema is one of the commonest reasons for this operation in our region, and treatment for the tuberculosis itself continues alongside surgery.

Dr. Muhibullah Dawar

Dr. Muhibullah Dawar

General, Laparoscopic, Thoracic and Laser Proctologist

FCPSGeneral Surgery
FellowshipLaparoscopic Surgery, CMH Rawalpindi
FCPS-IIThoracic Surgery, CMH Rawalpindi
Advance Surgery ClinicDabgari Garden, Peshawar
Medical references
NHS — Pleurisy NHS — Tuberculosis (TB)
Related procedures
Diseases of the Esophagus and Stomach Diseases of the Airways Lung Conditions Chest Wall Deformities Hiatus Hernia and Diaphragm Conditions Lung Resection All Thoracic Surgery
Medical disclaimer

This page describes a procedure in general terms so patients know what to expect. It is not medical advice and cannot replace an examination. Whether a procedure suits you, and what your recovery looks like, depends on your diagnosis, imaging, general health and how you respond to treatment — which is why every plan is made in consultation.

If you have severe abdominal pain, heavy rectal bleeding, a hernia that has become hard and painful, or sudden difficulty breathing, seek urgent care rather than waiting for an appointment.

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